Provider Demographics
NPI:1760909899
Name:STEGALL, LAUREN (LCMHC, NCC, LRT/CTRS)
Entity Type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:
Last Name:STEGALL
Suffix:
Gender:F
Credentials:LCMHC, NCC, LRT/CTRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 UNIONVILLE INDIAN TRAIL ROAD
Mailing Address - Street 2:SUITE B 202
Mailing Address - City:INDIAN TRAIL
Mailing Address - State:NC
Mailing Address - Zip Code:28079-4650
Mailing Address - Country:US
Mailing Address - Phone:704-234-8003
Mailing Address - Fax:704-220-0678
Practice Address - Street 1:120 UNIONVILLE INDIAN TRAIL ROAD
Practice Address - Street 2:SUITE B 202
Practice Address - City:INDIAN TRAIL
Practice Address - State:NC
Practice Address - Zip Code:28079-4650
Practice Address - Country:US
Practice Address - Phone:704-234-8003
Practice Address - Fax:704-220-0678
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-29
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13219101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty